Women’s History Month: Celebrating Melissa Arbuckle, MD, PhD, Columbia Psychiatry’s Vice Chair for Education and Director of Residency Training
When COVID-19 took Melissa Arbuckle to the front lines along with Columbia Psychiatry’s redeployed residents and fellows – she looked out for their physical and emotional health. As a leader, Dr. Arbuckle brought sensitivity, empathy, and support to our community in our time of need. When something needs doing, Dr. Arbuckle says she acts on the mantra of her mentor Dr. Maria Oquendo: “You have to push the system, it has to be a priority, and you make it happen.”
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Communications: Tell us about your work and what was changed by COVID-19?
Melissa Arbuckle, MD, PhD: In my role as residency training director, I oversee our psychiatry residents, and as vice chair for education I also oversee our clinical and research fellowship programs. Throughout this past year I’ve also been president of AADPRT, the American Association of Directors of Psychiatric Residency Training, helping people to share resources and ideas for managing the COVID crisis on a national scale. Obviously, the hardest part about COVID was the redeployment of our residents and fellows to the frontlines in terms of helping the medical teams manage the COVID surge they saw in our hospitals. Our residents were asked to work in ICU settings , which they may not have done before or at least not anytime recently, and they were asked to do critical care management with minimal training. I think that they felt proud of that contribution; the nature of the work was incredibly challenging, both in terms of managing acutely ill patients and the psychological aspects of the amount of patients who were dying and dealing with that trauma with the patients and families. It was very hard for me to ask the trainees to do this, but I knew that we needed every medical professional we had to serve.
Communications: What was hardest for you during the height of the pandemic, and are there pandemic related issues that you and those you supervise continue to face?
MA: Hardest at the height of the pandemic was that we didn’t know what was going to happen. We knew this was a deadly virus but we didn’t know how contagious it was, we didn’t know what to do to protect ourselves, and I worried that members of our team could catch COVID and die from it. The responsibility of sending people into harm’s way was really awful. But then I realized that I needed to create a way that our residents could do that and still feel supported, so we started regular check-ins with every resident who was redeployed and building in breaks so they would have time off between deployments.
Additionally, the prolonged disconnected community has been hard. Lot of residents are still working remotely and we’re incredibly grateful that we have that ability to do, but at the same time it’s really chipped away at our sense of community. We have residents that have been working from home for a year now, and the isolation, I think it’s really, really hard.
And then there are aspects of the surge that is actually still happening, so even though our residents have not been redeployed, Presbyterian Hospital has asked for remote back up for their medical teams. Residents are helping with discharge planning and getting additional history from family and doctors. Each resident across NYP and across specialties is being asked to contribute one day every two to four weeks. We’ve asked so much of our trainees.
Communications: You emphasize the lack of community because of everyone working remotely. Are you thinking about what you might do to offset that?
MA: Dr. Deborah Cabaniss, who’s one of our associate training directors, and I have regularly scheduled meetings with every resident. And it’s been really great, getting to know our residents with informal check-ins to see how they’re doing, and it’s been incredibly meaningful for me. It’s one of those things that, even when we go back to normal, I think we’ll continue to do because it’s been so valuable.
Communications: Do you have a plan to bring the residents back on site, or are you envisioning a future hybrid of some kind with more remote work and times when people will be together?
MA: I think the hardest part is that we’re still in this state of uncertainty; this idea of new variants, the rates of New York aren’t decreasing like I’d like to see and, personally, my kids are still doing largely remote schooling, so it’s hard to actually plan a path forward when there is so much uncertainty. But I do see that telehealth is here to stay. It’s been an incredible opportunity for people to have access to care, to eliminate logistical barriers for people getting care and I think that even if we move our operations back on site, many patients will want to continue to do telehealth and so it will be part of what we do. And while I want to make sure we’re onsite and I realize that sense of community that we’ve lost, I think this ability to work remotely has huge advantages, and particularly talking as a woman in terms of work-life balance and the extra time we have without the commute. Thinking about physician wellness, having a hybrid model is going to make sense for a lot of people. So we’ve been thinking about offering opportunities, if the clinical responsibilities allow people to work remotely, having some flexibility, but also maybe having certain community days were we ask for everyone to get on site so we can deliberately reconnect.
Communications: How did you come to medicine? Why psychiatry as a specialty, and then how did you get involved in being a leader of training?
MA: My mother suffered from depression, and I saw early on the devastating effects of mental illness and felt a real passion to help people that suffer from these illnesses, so I think that’s what first sparked my interest in psychiatry. My mother was a nurse, and when I was a little kid I would say, when I grow up I want to be a nurse and she said, No, you’re going to be a doctor. And my dad was a fifth grade schoolteacher, so I would intermittently fluctuate between going to be a teacher and going to be a doctor. So I love how my job combines both of these roles.
Communications: I’ve heard you in meetings and been so impressed with your empathy, generally, but specifically around issues of racism, diversity and inclusion; you're very sensitive in those areas and it's very clear they mean a lot to you. How do you think about the issue of diversity? About women in leadership roles? Do you have a grand plan for change, or do you take opportunities and make it happen?
MA: Well, I think this gets back to one of your other questions about models and mentors. Dr. Maria Oquendo, who was the training director before I stepped into this leadership role, really was a wonderful model of that, and she firmly believed and still believes in supporting and mentoring underrepresented students and supporting diversity, and she basically said you have to push the system, this has to be a priority, and you make it happen. And so I think that I learned a lot from that experience, and it has been incredibly rewarding to see the evolution of our residency program in terms of our current resident classes.
Communications: I was looking at the incoming residents -- at their pictures and their backgrounds, and they're very diverse in many different ways, even in terms of the schools they went to -- from public to Ivy League universities.
MA: Yeah, thank you. I'm really excited about that.
Communications: Thank you so much for spending time with us.